Prevalence of coronavirus disease 2019 in a multiethnic cohort of patients with autoimmune rheumatic diseases in Qatar

Karima Becetti; Eman Satti; Betsy Varughese; Yousef Al Rimawi; Rawan Sheikh Saleh; Nawal Hadwan; Miral H Gharib; Mohamed Awni Al Kahlout; Essa Abuhelaiqa; Hadil Afif Ashour; Rajvir Singh; Samar Al Emadi

doi:10.5339/qmj.2022.37

Prevalence of coronavirus disease 2019 in a multiethnic cohort of patients with autoimmune rheumatic diseases in Qatar

Qatar Med J. 2022 Aug 5;2022(3):37. doi: 10.5339/qmj.2022.37. eCollection 2022.

Affiliations

¹ Division of Rheumatology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail: becettikarima@gmail.com.
² Gastroenterology & Hepatology, Medicine, Hamad Medical Corporation, Doha, Qatar.
³ Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar.
⁴ Cardiology Research Center, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

Abstract

Background: Autoimmune rheumatic diseases (ARDs) are characterized by immune dysfunction and associated with an increased risk of infections, which were of significant concern during the coronavirus disease 2019 (COVID-19) pandemic. Variable rates of COVID-19 incidence have been reported in patients with ARDs; however, the true effect of this infection on this patient population is still unclear. We, therefore, aimed to evaluate the COVID-19 prevalence among a multiethnic cohort of patients with ARDs in Qatar.

Material and methods: We used telephonic surveys to collect demographic and clinical information of patients with ARD in Qatar between April 1 and July 31, 2020, including any close contact with a COVID-19 case at home or work and polymerase chain reaction (PCR)-confirmed COVID-19 diagnosis. An electronic medical records review was conducted to verify pertinent data collected through the surveys. Prevalence with 95% confidence interval (CI), Student's t-tests, and chi-square/Fisher's exact tests were used for univariate analyses, whereas multivariate logistic regression was used to identify factors associated with COVID-19.

Results: The study included 700 patients with ARD (mean age, 43.2 ± 12.3 years), and 73% were female. Until July 2020, 75 (11%, 95% CI 9%-13%) patients had COVID-19. Factors associated with COVID-19 included being a man (adjusted odds ratio [aOR] 2.56, 95% CI 1.35-4.88, p = 0.01) and having close contact with a COVID-19 case (aOR 27.89, 95% CI 14.85-52.38, p = 0.01). Disease severity and rheumatic medications had no significant association with the odds of contracting COVID-19. In the 86 patients with ARD having close contact, the frequency of hydroxychloroquine utilization was lower in patients who contracted COVID-19 than in those who did not (35% vs 72.5%, p = 0.01).

Conclusions: In Qatar, patients with ARDs had an overall higher prevalence of COVID-19 than global estimates. Being male and having close contact with a COVID-19 case were strongly associated with COVID-19 as reported globally. The presence of comorbid conditions, disease-specific factors, and rheumatic medications had no significant effect on the risk of COVID-19 in our study suggesting alternative mechanisms to the increased prevalence.

Keywords: Autoimmune disease; COVID-19; SARS-COV-2; disease-modifying anti-rheumatic drugs; rheumatic disease.